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Lee, Kim, Lee, Min, Kim, Kim, Sohn, Yoon, Shin, Park, Kang, and Park: A Case of Ectopic Cystic Thymoma
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2007; 62(4): 331-335.

Published online: 30 April 2007

DOI: https://doi.org/10.4046/trd.2007.62.4.331

A Case of Ectopic Cystic Thymoma

Jae Hyung Lee, M.D.1, Il Ok Kim, M.D.2, Hee Kyung Lee, M.D.2, Kyueng Whan Min, M.D.3, Sang Heon Kim, M.D.2, Tae Hyung Kim, M.D.2, Jang Won Sohn, M.D.2, Ho Joo Yoon, M.D.2, Dong Ho Shin, M.D.2, Chan Kum Park, M.D.3, Jung Ho Kang, M.D.4, Sung Soo Park, M.D.2

1Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea.

2Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Korea.

3Department of Pathology, College of Medicine, Hanyang University, Seoul, Korea.

4Department of Thoracic Surgery, College of Medicine, Hanyang University, Seoul, Korea.

Address for correspondence: Sung Soo Park, M.D. Division of Pulmonology, Department of Internal Medicine, College of Medicine, Hanyang University. 17 Haengdang-dong, Seongdong-gu, Seoul, Korea. Phone: 82-2-2290-8347, Fax: 82-2-2290-8366, parkss@hanyang.ac.kr

Received 23 January 2007       Accepted 2 April 2007

Copyright © 2007 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

A thymoma commonly occurs in the superior mediastinum or the upper part of the anterior mediastinum but can be located in other places in rare cases. Cystic degeneration in a thymoma is a relatively common but focal event. In rare cases, the process proceeds to the extent that most if not all of the lesion becomes cystic. We report a case of a patient with a paracardial cystic thymoma in the lower aspect of the anterior mediastinum. A 49-year-old woman was referred to our hospital because of a mass discovered incidentally on a chest X-ray. She showed no symptoms or signs. Contrast-enhanced chest CT scan revealed a 5×5cm sized, well-marginated, right paracardial cystic mass with a curvilinear and oval enhancing solid portion. A Surgical resection was performed. The mass was discontinuous with normal thymic tissue. Microscopy revealed a type B1 thymoma with prominent foci of medullary differentiation according to the WHO classification. There was no capsular or local invasion. The postoperative course was uneventful and the patient was discharged in good health.

Keywords: Ectopic, Cystic, Thymoma

Figures and Tables

Figure 1
Chest PA and lateral radiograph show a well-marginated right paracardial mass.
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Figure 2
Contrast-enhanced chest CT scan shows a well-marginated right paracardial cystic mass with curvilinear and oval enhancing solid portion.
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Figure 3
(A) Microscopy shows numerous lymphocytes with foci of medullary differentiation (H&E, ×40). (B) The neoplastic cells are predominantly lymphoid cells compared to few inconspicuous epithelial cells characterized by vesicular, clear nuclei and small nucleoli (arrow; H&E, ×40).
trd-62-331-g003

References

1. Sim EK, Lee CN, Mestres CA, Adebo OA. Ectopic thymoma: a case for median sternotomy for complete thymectomy. Singapore Med J. 1992. 33:407–408.
2. Suster S, Rosai J. Cystic thymomas. A clinicopathologic study of ten cases. Cancer. 1992. 69:92–97.
3. Yamazaki K, Yoshino I, Oba T, Yohena T, Kameyama T, Tagawa T, et al. Ectopic pleural thymoma a presenting as a giant mass in the thoracic cavity. Ann Thorac Surg. 2007. 83:315–317.
4. Fukai I, Funato Y, Mizuno T, Hashimoto T, Masaoka A. Distribution of thymic tissue in the mediastinal adipose tissue. J Thorac Cariovasc Surg. 1991. 101:1099–1102.
5. Moran CA, Suster S, Fishback NF, Koss MN. Primary intrapulmonary thymoma: a clinicopathologic and immunohistochemical study of eight cases. Am J Surg Pathol. 1995. 19:304–312.
6. Minniti S, Valentini M, Pinali L, Malago R, Lestani M, Procacci C. Thymic masses of the middle mediastinum: report of 2 cases and review of the literature. J Thorac Imaging. 2004. 19:192–195.
7. Kiyosue H, Miyake H, Komatsu E, Mori H. MRI of cervical masses of thymic origin. J Comput Assist Tomogr. 1994. 18:206–208.
8. Cohn LH, Grimes OF. Surgical management of thymic neoplasms. Surg Gynecol Obstet. 1970. 131:206–215.
9. Graeber GM, Thompson LD, Cohen DJ, Ronnigen LD, Jaffin J, Zajtchuk R. Cystic lesions of the thymus. An occasionally malignant cervical and/or anterior mediastinal mass. J Thorac Cardiovasc Surg. 1984. 87:295–300.
10. Soorae AS, Stevenson HM. Cystic thymoma simulating pulmonary stenosis. Br J Dis Chest. 1980. 74:193–197.
11. Suster S, Rosai J. Multilocular thymic cyst: an acquired reactive process. Study of 18 cases. Am J Surg Pathol. 1991. 15:388–398.
12. Lewis JE, Wick MR, Scheithauer BW, Bernatz PE, Taylor WF. Thymoma. A clinicopathologic review. Cancer. 1987. 60:2727–2743.
13. Verstandig AG, Epstein DM, Miller WT Jr, Aronchik JA, Gefter WB, Miller WT. Thymoma: report of 71 cases and a review. Crit Rev Diagn Imaging. 1992. 33:201–230.
14. Bernatz PE, Harrison EG, Clagett OT. Thymoma: a clinicopathologic study. J West Soc Periodontol Periodontal Abstr. 1961. 42:424–444.
15. Lattes R. Thymoma and other tumors of the thymus: an analysis of 107 cases. Cancer. 1962. 15:1224–1260.
16. Effler DB, McCormack LJ. Thymic neoplasms. J Thorac Surg. 1956. 31:60–82.
17. O'Gara RW, Horn RC Jr, Enterline HT. Tumors of the anterior mediastinum. Cancer. 1958. 11:562–590.
18. Wick MR. Assessing the prognosis of thymomas. Ann Thorac Surg. 1990. 50:521–522.
19. Masaoka A, Monden Y, NaKaHara K, Tanioka T. Follow up study of thymoma with special reference to their clinical stages. Cancer. 1981. 48:2485–2492.
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